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Effect of the Suture Method on Surgical Site Infection after Appendectomy and Cholecystectomy: a Retrospective Cohort Study.

Blaazer, A.M. (2019) Effect of the Suture Method on Surgical Site Infection after Appendectomy and Cholecystectomy: a Retrospective Cohort Study.

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Abstract:BACKGROUND: Surgical site infections (SSIs) are one of the most common complications in hospitals. Two frequently performed surgical procedures with a risk of developing an SSI are the appendectomy and cholecystectomy. A possible risk factor for SSIs is the suture method. The aim of this retrospective cohort study is to determine whether there is a difference in the incidence of SSIs between an intracutaneous suture and a transcutaneous suture after an appendectomy and cholecystectomy. METHODS: Patients who underwent an appendectomy or cholecystectomy in Medisch Spectrum Twente (MST) between January 2016 and December 2018 were included in this study. Several variables, among them SSI and the suture method, were collected from patient files according to the PREZIES guidelines. The primary outcome and the determinant were respectively SSI and suture method. Univariate chi-square test and multiple logistic regression were performed to determine the odds ratio, risk ratio and relevant confounders. RESULTS: A total of 1844 patients were included in this study (741 appendectomies and 1103 cholecystectomies). Different risk factors between the two groups were compared, such as surgical approach, urgency, type of appendicitis, wound classification, ASA index, malignancy, reoperation, age, duration of surgery and the closure method of the appendix stump. The rates of SSIs after appendectomy were 3.3% and 4.7% for respectively the intracutaneous group and transcutaneous group. The rates of SSIs after cholecystectomy without biliary pancreatitis were 9.3% for the intracutaneous suture and 3.2% for the transcutaneous suture. For the patients with biliary pancreatitis, the incidence rates were respectively 13.6% and 6.1% for the intracutaneous suture and transcutaneous suture. CONCLUSION: Before adjustment for confounding, there is a difference in the incidence of SSIs between the two suture methods for patients with a cholecystectomy without biliary pancreatitis. This difference disappears after adjustment for the surgical approach, so there is no significant difference in the incidence of SSIs between the two suture methods after an appendectomy and cholecystectomy. Also, the closure method of the appendix stump has no effect on the incidence of SSIs.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine, 70 social sciences in general
Programme:Health Sciences BSc (56553)
Link to this item:https://purl.utwente.nl/essays/78431
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